Comparison of two techniques for the evaluation of fetomaternal hemorrhage in RhD‐negative women: gel agglutination and haemoglobin F determination by flow cytometry

Ben-Haroush, Avi; Belkin, A.; Chezar, Judith; Orlin, Jerome; Hod, Moshe; Bar, Jacob

doi:10.1080/00016340701415509

Cited by 6 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…FMH was greater than 10 mL in 3 cases by KB, whereas by the microcolumn gel method FMH was at least 7.2 mL. This was in accordance with a study conducted by Ben-Haroush et al, 8 who found four episodes of FMH greater than 10 mL detected by flow cytometry and only one episode that was detected by gel agglutination method. Hence, for large-volume FMH, KB is required for FMH estimation, and the microcolumn gel method is not the test of choice.…”

Section: Discussionsupporting

confidence: 90%

Comparison of estimation of volume of fetomaternal hemorrhage using Kleihauer-Betke test and microcolumn gel method in D-negative nonisoimmunized mothers

Mittal¹,

Marwaha²,

Kumar

et al. 2013

Immunohematology

View full text Add to dashboard Cite

In this study we assessed the efficacy of the microcolumn gel method in the detection and quantification of the volume of fetomaternal hemorrhage (FMH) in comparison with the Kleihauer-Betke test (KB) in nonisoimmunized D-mothers. We collected blood samples from 80 D-indirect antiglobulin test-negative mothers over a span of more than 1 year. FMH was determined by KB and microcolumn gel method, and the results were compared. FMH was recorded as less than 4 mL by KB if no fetal cells were seen after examining 25 fields using 10× objective. If fetal cells were seen, slides were examined further to quantify FMH. By microcolumn gel method, FMH was reported as less than 0.1 percent, 0.1 percent, 0.2 percent, and 0.4 percent or greater. None of the patients had FMH greater than 15 mL by KB. Sixty-two patients (77.5%) had FMH less than 4 mL by KB. In all these cases, FMH was less than or equal to 0.2 percent (approximately 4 mL) by microcolumn gel method. The mean volume of FMH in the remaining 18 (22.5%) cases by KB was 8.3 ± 1.7 mL. Fifteen (83.3%) of these 18 cases had FMH of at least 0.4 percent (approximately 8 mL) by gel technology. Three cases (16.7%) that differed from KB results had FMH of 0.2 percent by microcolumn gel method with a maximal FMH of 6.4 mL by KB. FMH was significantly increased in cesarean delivery (mean FMH 9.5 ± 0.8 mL, range 7.9-10.4 mL, p = 0.001) and antepartum hemorrhage (mean FMH 9.5 ± 0.9 mL, range 7.9-10.4 mL, p < 0.001). Microcolumn gel method is an effective screening test. Technologies like KB and flow cytometry are better options for detecting a large volume of FMH. Antepartum hemorrhage and cesarean delivery are risk factors for FMH. The 300-µg dose appears to be excessive immunoprophylaxis in the majority of cases. We need to analyze the relative cost-effectiveness of universal administration of 300 µg of Rh immune globulin vs. FMH quantitation with subsequent administration of titrated doses. Immunohematology 2013;29:105-09.

show abstract

Section: Discussionsupporting

confidence: 90%

Comparison of estimation of volume of fetomaternal hemorrhage using Kleihauer-Betke test and microcolumn gel method in D-negative nonisoimmunized mothers

Mittal¹,

Marwaha²,

Kumar

et al. 2013

Immunohematology

View full text Add to dashboard Cite

show abstract

“…Moreover, the use of monoclonal antibodies (e.g., anti-HbF) that we used in our study ensures high specificity and repeatability of the reaction with the antigen, making cytometric tests specific and sensitive. Due to their high specificity, immunoglobulins may be used at very low concentrations, eliminating the tendency to cross-react with other proteins and non-specific binding [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Is Feto-Maternal Transfusion after Cesarean Delivery Different in Singleton and Twin Pregnancy?

Stachurska-Skrodzka,

Mielecki,

Fijałkowska

et al. 2024

JCM

View full text Add to dashboard Cite

Background: The aim of the study was to investigate if feto-maternal transfusion was related to the size of the fetal-maternal interface, and, therefore, was larger in twin pregnancy in comparison with singleton pregnancy. Methods: Blood samples from women with singleton (n = 11), and monochorionic (n = 11) and dichorionic (n = 13) twin gestations were tested. Flow cytometry tests with hemoglobin F, glycophorin A, and hemoglobin F and carbonic anhydrase simultaneous staining were used to detect fetal red blood cells and maternal F cells. Results: In all cases, the volume of feto-maternal transfusion was estimated to be low. The highest rate of fetal red blood cells in the maternal circulation was observed in the blood of women with dichorionic twin gestations both before and after delivery. An increase in fetal red blood cells was observed after cesarean section in singletons and twins. The median rate of maternal F cells was 2.23% in singleton, 2.1% in monochorionic and 3.95% in dichorionic pregnancy. Conclusions: Feto-maternal transfusion during pregnancy may be related to the multiplicity and chorionicity of pregnancy.

show abstract

“…The authors reported that their gel agglutination card assay had comparable sensitivity with the acid-elution staining assay and detected all admixtures of D+ RBCs that were greater than 0.2 percent. 28,29 Ben-Haroush and colleagues 30 analyzed blood samples from 118 D-postpartum women for fetal RBCs by both gel agglutination and flow cytometry (anti-HbF), and reported that the gel agglutination test failed to detect FMHs reliably in the range of 0.1 to 10.0 mL. Subsequently, Agaylan and colleagues 31 described a particle gel immunoassay using superparamagnetic particles coated with monoclonal anti-D.…”

Section: Gel Agglutination Cardsmentioning

confidence: 99%

Laboratory methods for Rh immunoprophylaxis: a review

Sandler¹,

Sathiyamoorthy

2010

Immunohematology

View full text Add to dashboard Cite

The recommended dose of Rh immune globulin for postpartum Rh immunoprophylaxis is based on an estimation of the volume of the fetomaternal hemorrhage, if any, measured as the percent of fetal RBCs in a sample of the D-mother's blood. Laboratory methods for distinguishing fetal from maternal RBCs have been based on their different blood types (D+ versus D-) or predominant hemoglobin content (hemoglobin F versus hemoglobin A). We conducted a review of the medical literature describing laboratory methods for detecting and quantifying fetal RBCs in maternal blood samples. We also used data collected for the College of American Pathologists Fetal RBC Detection Surveys to determine which laboratory methods are used currently in hospitals in the United States. The rosette screen is used widely for identifying D-mothers who may require additional doses of Rh immune globulin for postpartum immunoprophylaxis. As the rosette screen targets the D antigen, it is not suitable for detecting a fetomaternal hemorrhage in D+ mothers or when the D type of the fetus or newborn is D-or unknown. The acid-elution (Kleihauer-Betke) assay is a sensitive laboratory method for quantifying a fetomaternal hemorrhage, but it is tedious, often inaccurate, and difficult to reproduce. Flow cytometry, using anti-D or antihemoglobin F reagents, offers a more precise quantification of fetal RBCs in maternal blood. However, flow cytometry services for this function are available in relatively few hospital laboratories in the United States because of logistic and fiscal impediments.

show abstract

Comparison of two techniques for the evaluation of fetomaternal hemorrhage in RhD‐negative women: gel agglutination and haemoglobin F determination by flow cytometry

Abstract: The gel agglutination technique, as used in the range of 0.1-10 ml, is not sensitive enough to detect FMH.

Cited by 6 publications

References 27 publications

Comparison of estimation of volume of fetomaternal hemorrhage using Kleihauer-Betke test and microcolumn gel method in D-negative nonisoimmunized mothers

Comparison of estimation of volume of fetomaternal hemorrhage using Kleihauer-Betke test and microcolumn gel method in D-negative nonisoimmunized mothers

Is Feto-Maternal Transfusion after Cesarean Delivery Different in Singleton and Twin Pregnancy?

Laboratory methods for Rh immunoprophylaxis: a review

Contact Info

Product

Resources

About